Uniform Referral

Magisterial District Judge

PARTY 1 INFORMATION

PARTY 2 INFORMATION

(For matters involving more than 2 parties, please use the fields below. If only two parties, jump to the bottom. Please review your information before submitting.) 

PARTY 3 INFORMATION

PARTY 4 INFORMATION

PARTY 5 INFORMATION

In the above cited matter, I have referred these parties to Neighborhood Dispute Settlement for mediation services. I have reviewed my information and included all information relevant to this matter.

Thank you! We have received your form!

Please allow forty-five (45) to sixty days (60) for resolution of this matter through mediation.

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